The overlooked mental health burden of polycystic ovary syndrome: neurobiological insights into PCOS-related depression

Polycystic ovary syndrome (PCOS) is a prevalent endocrine disorder affecting 6-13% of reproductive-aged women worldwide. It is primarily characterized by ovarian dysfunction, hyperandrogenism, and metabolic disturbances. However, women with PCOS also face a heightened risk of depression, possibly due to dysregulation in endocrine and immune systems and gut microbiome disturbances. Symptoms of PCOS such as infertility, obesity, and hirsutism can also cause psychological distress and further exacerbate depression symptoms. Despite this comorbidity, mental health aspects of PCOS are often overlooked in the medical field, leading to insufficient support and negative impacts on the quality of life of PCOS patients. This review explores how distinct PCOS phenotypes influence physiological and psychological outcomes and the possible biological mechanisms involved. We also examine the effects of existing treatments on PCOS symptoms and depression. Addressing both physiological and psychological challenges is crucial for developing targeted, personalized interventions that improve outcomes for individuals diagnosed with PCOS.